Open Access Highly Accessed Research article

Assessing the level of healthcare information technology adoption in the United States: a snapshot

Eric G Poon125*, Ashish K Jha145, Melissa Christino1, Melissa M Honour1, Rushika Fernandopulle3, Blackford Middleton1256, Joseph Newhouse47, Lucian Leape4, David W Bates12456, David Blumenthal35 and Rainu Kaushal135

Author Affiliations

1 Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA

2 Clinical Informatics Research and Development, Partners Information Systems, Partners HealthCare, Wellesley, MA, USA

3 Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA

4 Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA

5 Department of Medicine, Harvard Medical School, Boston, MA, USA

6 Center for Information Technology Leadership, Partners Healthcare, Wellesley, MA USA

7 Kennedy School of Government, Harvard University, Cambridge, MA, USA

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BMC Medical Informatics and Decision Making 2006, 6:1  doi:10.1186/1472-6947-6-1

Published: 5 January 2006



Comprehensive knowledge about the level of healthcare information technology (HIT) adoption in the United States remains limited. We therefore performed a baseline assessment to address this knowledge gap.


We segmented HIT into eight major stakeholder groups and identified major functionalities that should ideally exist for each, focusing on applications most likely to improve patient safety, quality of care and organizational efficiency. We then conducted a multi-site qualitative study in Boston and Denver by interviewing key informants from each stakeholder group. Interview transcripts were analyzed to assess the level of adoption and to document the major barriers to further adoption. Findings for Boston and Denver were then presented to an expert panel, which was then asked to estimate the national level of adoption using the modified Delphi approach. We measured adoption level in Boston and Denver was graded on Rogers' technology adoption curve by co-investigators. National estimates from our expert panel were expressed as percentages.


Adoption of functionalities with financial benefits far exceeds adoption of those with safety and quality benefits. Despite growing interest to adopt HIT to improve safety and quality, adoption remains limited, especially in the area of ambulatory electronic health records and physician-patient communication. Organizations, particularly physicians' practices, face enormous financial challenges in adopting HIT, and concerns remain about its impact on productivity.


Adoption of HIT is limited and will likely remain slow unless significant financial resources are made available. Policy changes, such as financial incentivesto clinicians to use HIT or pay-for-performance reimbursement, may help health care providers defray upfront investment costs and initial productivity loss.